Regional variation in prevalence of frailty in India: Evidence from longitudinal ageing study in India (LASI) wave-1

Background & objectives Frailty is a geriatric syndrome with clinical and public health implications. It represents the state of increased vulnerability. This study aimed to estimate the prevalence of frailty and pre-frailty by demographic characteristics and geographical regions in India. Furthermore, it also aimed to examine the association of this prevalence with selected health outcomes using data from the Longitudinal Ageing Study of India (LASI). Methods This is a secondary analysis of LASI wave-1 data. A total of 26,058 respondents aged ≥60 yr were included for analysis. Frailty was assessed using Fried's frailty phenotype, including slowness, shrinking, low physical activity, weakness, and low endurance. Descriptive statistics were used to study frailty distribution. The odds ratio (OR) of health events across the frailty categories was computed using ordinal logistic regression. Results The findings of this study suggest that the prevalence of frailty and pre-frailty was 29.2 and 58.8 per cent, respectively. The prevalence of frailty was higher among women (37.3%), illiterate (37%) and rural residents (31%). It ranged between 14.5 per cent in Uttarakhand and 41.3 per cent in Arunachal Pradesh. Frailty was strongly associated with depression [OR: 2.09, Confidence Interval (CI): 1.98-2.21] and activities of daily living (ADL) difficulty (OR: 1.75, CI: 1.64-1.86). Higher odds were reported for fracture (OR: 1.24, CI: 1.01-1.51) and multimorbidity (OR: 1.18, CI: 1.04-1.33) among frailty. Interpretation & conclusions The heterogeneity of frailty prevalence across States indicates the need for population-specific strategies. A sharp age-related increase in prevalence highlights the need for preventive measures. Furthermore, the high prevalence of frailty among women, illiterate and rural residents indicates the target population for receiving preventive interventions. Lastly, a heterogeneity in frailty prevalence across different States indicates the scope for region-specific programmes.